Nathan Michael Benjamin, PTA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5502003080 Issued in MI

Practice address

1235 S Center Rd Ste 12
Burton, MI 48509-1700

Phone

(810) 743-8820

Fax

(810) 743-5908

NPI assigned

Jan 10, 2011

Last updated

Jan 10, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1659675346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 LIONS GATE PKWY",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484233195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 S CENTER RD STE 12",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091700",
            "telephone_number": "810-743-8820",
            "fax_number": "810-743-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5502003080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samir Basata, MD
• Meredith Bauer, PHARMD
• Amanda Dee Beagle
• Blake Donald Beauchamp, DO
• Belsay Medical Pharmacy Inc
• Noah Benjamin
• Amanda J Benoit
• Summer Elizabeth Bentley
• Deidre Berry
• Bertram Haus

• Physical Therapy Clinic/Center in Burton, MI
• Providers in Burton, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.